Article

Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Updates and MSP Portal Enhancements

… has made enhancements to the Medicare Secondary Payer Recovery Portal (MSPRP) and has issued an updated version (v 4.9) of the MSPRP User Guide to coincide with the enhancements. As you may … 4) Password/Account Recovery Assistance … A new Forgot Password feature on the Welcome to the MSPRP page allows users to unlock their account, if locked after three unsuccessful login attempts, or to reactivate an inactive account (Sections 6.3, 6.4, 7.5, and 18.7). …
Article

Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Updates and MSP Portal Enhancements

… has made enhancements to the Medicare Secondary Payer Recovery Portal (MSPRP) and has issued an updated version (v 4.9) of the MSPRP User Guide to coincide with the enhancements. As you may … 4) Password/Account Recovery Assistance … A new Forgot Password feature on the Welcome to the MSPRP page allows users to unlock their account, if locked after three unsuccessful login attempts, or to reactivate an inactive account (Sections 6.3, 6.4, 7.5, and 18.7). …
Article

Total Loss Trends Emerge Amidst the Pandemic

… and must make decisions that best serve its employees and customers, we are already witnessing an acceleration of virtualization adoption in the auto claims industry due to the spread of …
Article

Revolutionizing Specialty Services Management

… with catastrophic (CAT) claims , where costs can surge dramatically.  Although CAT injuries account for only 1% of claims, they can consume 15% to 20% of total spend. Efficiency Through … smoother operations. Outdated multi-vendor coordination or poor customer service are no longer an option. A modern approach to specialty services management requires: … potential. Unmatched Expert Support  Apricus connects claims handlers to a live expert in an average of just 10 seconds, delivering prompt and efficient support exactly when it’s needed. …
Article

Measuring and Driving Performance in a Technology Shocked Industry

… in the complexity of vehicles over the last five years is absolutely staggering. We live in an age where every aspect of the automobile is being transformed. Cars are now being produced … as their primary propulsion system for future models. These factors have created an environment where collision repairs are rapidly becoming much more costly than ever before, … There are four primary steps to implementing an effective performance management strategy: …
In the News

The Mental Side of an Injured Worker’s Recovery
Article

Five Qualities of an Effective Business Workflow Solution

… and easily. This includes being able to update business rules within the rules engine in an efficient manner. A rules engine is not as valuable if a company has to contact an external vendor to request rule changes every time it needs a rule modification. This type of approach may take weeks and can be an expensive process. To help solve this problem, the rules engine must be easy enough to setup, …
Author

Craig Prince

… Committee functions and operating clinical programs focused on opioid mitigation. Prince is an accomplished healthcare business professional, broadly experienced over his career in enterprise market development, national account management and clinical roles in the pharmaceutical, medical device and managed care …
Article

Long-Lasting Pandemic Trends That Might Surprise You

… reliance, originally caused by a need to stay protected from the virus, evolved into an expectation from consumers across all kinds of industries—including P & C. Insurance companies … Last year, we not only relied on apps to connect with others or to buy commercial goods. We also began to rely on them for peace of mind. In April of 2020 mental … we have also heard plenty of rhetoric about employees who found that working at home gave them an opportunity to relocate from expensive city centers to more rural areas, where property was …
Blog

Aggregate Trends for Top 10 Therapeutic Classes in 2019

… In 2019, the top 10 therapeutic classes accounted for 76.8% of all scripts and 79.6% of all costs. An understanding of the most-utilized and highest-ranked classes of medications by cost can drive … may warrant further evaluation for appropriateness and safety. Watch the video blog here . Top TC …
Blog

Aggregate Trends for the Top 10 Therapeutic Drug Classes in 2018

… In 2018, the top 10 therapeutic classes accounted for 77.1% of all scripts and 81.0% of all costs. An understanding of the most-utilized or highest-ranked classes of medications by cost can help …
Podcast

Do You Need a Medicare Set-Aside?

… And, who is a good candidate for an MSA? … or work credits in the Social Security system. So, you have to pay into the system and work an adequate amount of time, I think it's five out of the last 10 years, to be fully insured or be … Is the process difficult to obtain an MSA? … No, the process is fairly simple to obtain an MSA. You could contact an MSA vendor. At Genex, what we request is that you provide the …
Podcast

Is Your Workplace Safe2Work?

… efficient ways to keep work environments safe from COVID-19, Optis has developed Safe2Work, an app-enabled, web-based health screening program designed to help stop the spread of workplace … to help the employee come back faster. That is why we decided to build the Safe2Work app on top of that and add it into this very robust system for trackability and ability to actually … with claims just like Jacob said earlier. So, for instance, you can jump in FMLA, and follow an FMLA claim all the way through if that’s the course that they want to go through. And, with …
Author

Julie Black

… clinical program management, Drug Utilization Assessments and Provider Outreach, and clinical account management. Prior to joining Pharmacy Solutions, Julie served as a clinical liaison for a … industry having worked previously in the areas of clinical operations, product development and account management. In addition, Julie has experience outside of workers’ comp, including …
Conference

Enlyte Envision 2024

… the latest technology, service and claims advancements from Enlyte’s family of brands. This is an exclusive event focused on the most impactful innovations, insights and issues facing claims … management. Interested in learning more about the conference? Contact your Customer Success or Account Executive for more information. Registration opens in the summer of 2024. …
Article

An Overlooked Essential: Hospital Discharge Planning in Workers’ Compensation
Article

Top 20 Reasons to Consider an Independent Medical Exam

… and cost-effective claim resolution. But how do you know if your claim could benefit from an Independent Medical Examination? Outlined below are 20 reasons you should consider an IME. … From clarification of diagnosis to return to work, an IME can bring clarity to your claim.  … recommended 8. Provider has not provided a prognosis for recovery 9. Provider is treating an unrelated body part 10. Provider is not addressing the individual’s functional capabilities …
Article

5 Steps to an Optimized Third Party Liability Claim Workflow

… to optimize their third party liability claim workflow for adjusters and claimants alike in an effort to build a competitive advantage and respond to the changing environment. Emerging … tasks such as organizing demands and other paperwork related to a claim. This is an opportunity for efficiency gains within an organization that is currently relying on adjusters to sort through and organize demands. …
Author

Randy McKinney

… increasing responsibilities. His strong competencies exhibited as area sales manager, regional account executive, and regional manager serve as an excellent foundation. Prior to serving in his current position, McKinney was Genex’s southeast …
Blog

Brand and Generic Trends in Managed and Unmanaged Populations

… they have come to rely on.” Luckily, we can see that same quality-value balance play out with an increasing number of the prescription medications clinicians are using to treat injured … of all managed prescriptions, increased for the seventh straight year. There was also an increase in generics among unmanaged prescriptions, which fall outside the contracted networks … rate for topicals rose 5.5% points to 92.6%. This was the biggest increase among the top 10 drug classes. Beyond an increase in the use of generic medications, there were other signs …
Blog

Managed vs. Unmanaged — A View Into All Pharmacy Transactions and the Differences Between Their Claim Populations

… make clear that care should be taken when making comparisons and generalizations across an entire book of business. Just think of that next time you look at the night sky: What isn’t …
Article

Plugged-In: EV Collision Insights Q1 2023

… time in Q1 2023 with the Rivian R1T slowly gaining ground as well but still well outside the top 10 most frequently repaired EVs.   EV Frequency of Repairable Claims Volume Q1 2023 EVs … labor hours on average than their ICE counterparts but also more refinish hours with an average of 8.33 compared to 7.4 for the rest of the market. A closer look at these numbers by … interconnected vehicles to OEM standards. Automotive insurers, on the other hand, will need to account for higher than average repair costs and cycle time when determining policyholder …
Podcast

Medication Safety: How Do We Solve the Problem?

… multimedia series in which subject matter experts discuss problems and offer solutions to top issues affecting our industry. I’m Tom Kerr, and in part two of our discussion, Ron Skrocki, … use nurses. So, if you believe that and you believe that and believe that's the right model in an era of medical technology change, of big data, of expert systems, of analytics, then you're … process, which commits only to paying transactions that the adjuster decides they want to buy on a micro level. So, it’s a macro level spend decision that today many carriers just don't …
Article

Federal Regulatory and Legislative Trends Affecting Property & Casualty

… People having a discussion at an Enlyte Conference … only in an inpatient setting … defer to clinical judgment as to whether those particular procedures would be performed in an inpatient or outpatient setting. Some could obviously only be done in an inpatient setting depending upon the individual patient; however, for others, it is a clinical …
News Release

Mitchell Issues 3rd Quarter 2019 Industry Trends Report

… The strong U.S. economy continues to have an impact on consumer behavior, driving patterns, and thus, the trajectory of auto collision … The Casualty Edition: The Power of an Optimized Workflow Technology … $1.7 to $8.9 billion in potential cost savings within five to seven years. In the “ Power of an Optimized Workflow Technology ,” Shahin Hatamian, Senior Vice President, Product Development, …
Article

The Compliance Corner: Opt-Out, an Alternative Workers' Compensation Model

… for deregulation of payment for workers’ compensation claims at the state level. Opt-out is an alternate compensation model for the injured worker whereby employers choose to opt-out of … the International Association of Industrial Accident Boards and Commissions (IAIABC) published an analysis of the treatment of occupational injuries and illnesses under state workers’ …
Conference

AASCIF Annual Conference

… The AASCIF Annual Conference brings together state funds from across the country every year for an event full of insights, education and networking. Mitchell is the platinum sponsor for this … success Industry trends, including formulary changes and other compliance issues. Contact your account manager or click here to schedule a meeting with Mitchell at AASCIF. …
Article

AI and Ergonomics: Merging Technology with Human Expertise for Optimal Workplace Solution

… replicate the nuanced expertise that human ergonomists bring to the table. Ergonomists play an essential role in translating AI-driven insights into actionable, personalized, and … data, but they lack the human ability to understand context and complexity. For example, an AI system might flag a certain posture as problematic, but only an ergonomist can interpret the broader context behind that behavior. Why is a worker adopting …